Healthcare priorities: Peripheral neuropathy and hypertension in patients with type 1 diabetes

HealthCare Priorities: Peripheral Neuropathy and Hypertension

This interview with Miss Rachel Robbin (pseudonym). She is a 59 year old woman who came to Australia in 2007 from India. In 2007, when she and her family immigrated to Australia, she was diagnosed with non-insulin diabetes. Since she has a full-time job and two growing children, she cannot control her diabetes. In 2013, she was diagnosed with type 1 diabetes and started taking insulin. Her medical history included peripheral neuropathy, hyperlipidemia, high blood pressure, iron deficiency, vitamin D deficiency, GERD, mild microalbuminuria, and moderate nonproliferative retinopathy (associated with the case). ). This article discusses two of Rachel’s healthcare priorities, peripheral neuropathy and hypertension. Both preferences will be explained by the RLT model. Health behavioral modeling was used to help Rachel manage her condition. In type 1 diabetes, the pancreas produces little or no insulin. The body recognizes insulin as a foreign substance and begins to destroy it. This is an autoimmune reaction (DiMeglio, Evans-Molina & Oram, 2018). Diabetic fatigue is more than just a feeling of fatigue and can contribute to increased hopelessness. Hypertension, commonly known as high blood pressure, is a major cause of cardiovascular disease (CVD) worldwide. In hypertensive patients, poor adherence to medication is common. There is often a lack of a unified model for evaluating these aspects.

The Health Belief Model (HBM) is a model of cognitive and internal health behavior. This health model was first created in the 1950s and then updated around the 1980s (Green, Murphy & Gryboski, 2020). This concept is based on the assumption that patients’ tendency to change health-related practices is largely driven by their health-related beliefs. According to this model, a particular individual’s views of their health and health problems play a role in their choice of health-related activities (Green, Murphy, & Gryboski, 2020) ). HBM is an “expected value” model. It aims to describe and estimate health-related behaviors by focusing on the mindsets and thought processes of people and communities. This model includes six perceived domains as susceptibility, perceived severity, perceived benefit, perceived barriers, action cues, and modifiers. It is considered one of the most influential models in the history of the health promotion industry, and it has proven its effectiveness in predicting health-related behaviors of many populations. have or are at risk for peripheral neuropathy and high blood pressure (Luquis & Kensinger, 2019).

The first priority is the management of peripheral neuropathy. Rachel was diagnosed with type 2 diabetes and started taking insulin. As mentioned in the interview, his medical history includes peripheral neuropathy. Peripheral neuropathy is nerve damage caused by diabetes and persistent high blood sugar. There are a number of reasons that lead to peripheral neuropathy, such as high blood sugar that prevents access to vital nutrients to other body organs such as the feet and legs. In addition, it causes numbness, altered sensation, and discomfort in the feet, legs, or hands (Agarwal, 2018). The RLT model was largely created to consider the psychological, biological and social needs of the patient with the goal of providing a comprehensive therapeutic strategy (Williams, 2017). The RLT model includes twelve daily tasks: maintaining a healthy atmosphere, skills for effective communication, breathing, eating and drinking, excreting, bathing and dressing, temperature regulation, movement, work and play, show sexual orientation, sleep and die. In Rachel’s case, she worked in an old PCA almost 5 days a week. She cannot have a healthy diet because she is always busy with work and raising children. She has to do all her work. She barely had time to exercise because Rachel was tired after a long day at work and overslept (Holland & Jenkins, 2019).

Using RLT models for therapy

If this condition is not controlled, it can lead to missed hypoglycemia. Rachel may not notice the signs of low blood sugar. The reason for leg amputation in diabetic neuropaths is due to loss of sensation, they do not notice small cuts and lesions, if not treated, can cause foot infections, eventually leading to gangrene. . It can also cause sudden low blood pressure. It can also lead to digestive problems as well as sexual dysfunction (Bodman & Varacallo, 2021). The nurse must educate Rachel about ABC so she can take steps to prevent the disease she is suffering from. She must believe that if she does not control her condition, it can lead to serious complications (Abedzadeh Zavareh & Sayehmiri,). Support A1C blood test. The A1C is a blood test that shows Rachel’s average blood sugar over the past few months. B indicates blood pressure. Rachel must believe that regulating her blood pressure is just as important as controlling her blood sugar because she has diabetes. High blood pressure puts her at risk for heart attack, stroke, and kidney damage (Delahanty, 2021). C stands for cholesterol Rachel’s medical history suggests hyperlipidemia, which is another risk factor that can increase the risk of many serious problems. Rachel should aim for an A1C below 7%, blood pressure below 140/90 or even lower, and LDL cholesterol below 100 (Delahanty, 2021).

The Health Belief Model will help Rachel track her lifestyle and lead a better life. Rachel should monitor her blood sugar daily if she believes in the importance of living a healthy life. Rachel should believe that her choices about the food she eats and the way she lives have a huge impact on her overall health. She should make healthy food choices, such as eating plenty of fruits, vegetables, whole grains, and low-fat dairy products. Mothers should avoid eating meat or fried, greasy foods. She needs to be active and exercise at least 30 minutes three times a week. She has to take care of her feet. She should wash it regularly and properly moisturize it. She has to cut her fingernails and wear clean, dry socks (NIDDK, 2016).

Rachel’s second priority is to control her hypertension. Rachel’s medical history includes high blood pressure and she takes metoprolol to control her blood pressure. In diabetes, the blood vessels are damaged by high blood sugar levels causing them to harden leading to atherosclerosis. This condition, if not treated promptly, can lead to high blood pressure, which in turn leads to complications such as blood vessel damage, heart attack, retinopathy, and kidney failure. The second priority RLT consideration is that Rachel can successfully converse, listen, and speak without the aid of any kind of support or challenge. She also joins community services to talk to the elderly because after the blockade, most of them are afraid to leave the house due to the increase in the number of covid cases. There was no evidence of dyspnea, no signs of respiratory distress, and no reports of pain during that time. Respiratory. She loves to sing, cook for her children and loves Indian clothes. She cannot have a healthy diet because she is always busy with work and raising children. She barely had time to practice because Rachel was tired after a long day of work and overslept.

Health belief model to guide health behaviors

High blood pressure puts excessive pressure on artery walls, which can damage both blood vessels and organs. The longer the blood pressure is left unchecked, the more damage it can cause. High blood pressure can promote hardening and thickening of the arteries, also known as atherosclerosis, which can lead to heart attack, stroke, or other problems (Fuchs & Whelton, 2020). Aneurysms can occur when blood vessels degenerate and enlarge due to high blood pressure. If an aneurysm bursts, it can be fatal. This can lead to heart failure. It can also cause weakening and narrowing of the veins and arteries in the kidneys. Blood vessels in the eye thicken, constrict, or tear due to high blood pressure. This can lead to vision loss (Riley, Hernandez & Kuznia, 2018).

In terms of care seeking and adherence, a patient’s ability to seek medical care and adhere to a treatment plan is influenced by a number of factors. These include personal insights, patient interests and perspectives, changing circumstances, and behavioral cues (Khalil & Tartour, 2017). High blood pressure can be controlled with dietary changes and in some cases medication. Rachel should believe she needs to develop a strategy to get her blood pressure back to normal. She should consume a diet rich in fiber and potassium. His diet should be low in sodium, fat and added sugars. Rachel should eat a variety of fresh fruits and vegetables. She should eat whole grains, including whole-wheat pasta, brown rice, and whole-grain bread. She should consume low-fat dairy products. She should avoid fatty cuts of meat, cooked or preserved meats, birds with skin on, and prepared meals. Rachel must maintain a body weight that is considered healthy. If she is overweight or obese, she should lose weight. She needs to be active and exercise at least 30 minutes three times a week. She should include exercises that can strengthen her muscles. She must not use any items containing nicotine or tobacco. She needs to manage her long-term health problems like diabetes and hyperlipidemia. She needs to manage her stress and indulge in activities like yoga, meditation, etc. (Gabb, et al., 2016). Through this model, Rachel will understand the severity of the disease and the importance of managing it.

In summary, it can be said that chronic diseases such as diabetes, high blood pressure can lead to many health problems such as cardiovascular, kidney, etc. Appropriate nursing education and interventions can help her manage her conditions and live a healthy life. Nurses and healthcare providers will discuss the importance of self-care for diabetes and hypertension in the next step. Topics such as glucose monitoring, medication adherence, regular exercise, eating healthy foods, and weight control should be addressed. The education provided on these topics will help manage the patient’s HbA1C levels as well as blood sugar levels. This will help the patient maintain a healthy weight and stay physically fit. It will also help control high blood pressure as well as high blood sugar and improve quality of life.


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Agarwal, S. (2018). How Diabetes Affects Your Body (And What You Can Do About It). diabetes.

Bodman, M. A., & Varacallo, M. (2021). Peripheral diabetic neuropathy. In StatPearls [Internet]. StatPearls Publishing.

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DiMeglio, L. A., Evans-Molina, C., & Oram, R. A. (2018). Type 1 diabetes. The Lancet, 391(10138), 2449-2462.

Fuchs, F. D., & Whelton, P. K. (2020). High blood pressure and cardiovascular disease. Hypertension, 75(2), 285-292.Gabb, G. M., Mangoni, A. A., Anderson, C. S., Cowley, D., Dowden, J. S., Golledge, J., … & Arnolda, L. (2016). Guideline for the diagnosis and management of hypertension in adults—2016. Medical Journal of Australia, 205(2), 85-89.

Green, E. C., Murphy, E. M., & Gryboski, K. (2020). The health belief model. The Wiley encyclopedia of health psychology, 211-214.

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Luquis, R. R., & Kensinger, W. S. (2019). Applying the health belief model to assess prevention services among young adults. International Journal of Health Promotion and Education, 57(1), 37-47.

NIDDK. (2016). Diabetes Diet, Eating, & Physical Activity.

Puspita, R. C., Tamtomo, D., & Indarto, D. (2017). Health belief model for the analysis of factors affecting hypertension preventive behavior among adolescents in Surakarta. Journal of Health Promotion and Behavior, 2(2), 183-196.

Shabibi, P., Zavareh, M. S. A., Sayehmiri, K., Qorbani, M., Safari, O., Rastegarimehr, B., & Mansourian, M. (2017). Effect of educational intervention based on the Health Belief Model on promoting self-care behaviors of type-2 diabetes patients. Electronic physician, 9(12), 5960.

Riley, M., Hernandez, A. K., & Kuznia, A. L. (2018). High blood pressure in children and adolescents. American family physician, 98(8), 486-494.

Williams, B. C. (2017). The Roper-Logan-Tierney model of nursing. Nursing2020 Critical Care, 12(1), 17-20.

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